Sunday, February 07, 1999
"The healing time of fresh fractures takes on average 104 days," said co-author Joseph M. Lane, MD, professor of surgery (orthopaedics) and assistant dean, medical students, Cornell University Medical College, New York. "The two most important influences on patient outcomes are patient age and fracture age. However, smoking, obesity and steroids adversely affect union rate significantly."
Researchers at the Hospital for Special Surgery, New York examined patient demographics, outcomes, fracture type and time to union of all patients treated with ultrasound in the ultrasound prescription-use database through January 22, 1998. Dr. Lane and colleagues analyzed the patient database with specific attention to sex, ethnic origin, bone, diabetes, alcoholism, infection, NSAIDs, obesity, steroid use, age of fracture and patient age. The results were presented Friday in poster exhibit 245.
According to Dr. Lane, patient age and treatment timeliness affect the outcome of fractures treated with low-intensity pulsed ultrasound.
"Treatment of delayed unions, starting 91 to 269 days postfracture had a 91 percent healing rate and 122-day healing time," he said. "For nonunions, where treatment began 270 days or more after injury, the healing rate was 84 percent and the healing time was 153 days."
Noting that open fractures and fractures of the humerus are associated with an increased failure rate, Dr. Lane said that being older and having an older fracture is highly correlated with an increasing tendency to fail.
"Ultrasound treatment has been applied to a broad distribution of fracture locations and stages of delay," he said. "Ultrasound therapy successfully heals acute radius and tibial fractures compared to placebos. The current prospective study tests the hypothesis that time of application of the ultrasound would affect the union rate. The secondary goal was to determine those risk factors that adversely affect fracture union."
Co-authors of the study with Dr. Lane are Margaret Paterson, PhD, Hospital for Special Surgery; John P. Ryaby, Exogen, Inc., Essex Fells, NJ; and Fred Testa, Piscataway, NJ.